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If you’ve heard rabbit sound like wabbit, it’s possible that you’re on the receiving end of one of the most challenging and treatment-resistant speech sound disorders—misarticulation of the letter “r.” Research by the National Institute on Deafness and Other Communication Disorders has shown that approximately 10 percent of preschool and elementary school children are affected by speech sound disorders.

According to Steinhardt School of Culture, Education, and Human Development professor Tara McAllister Byun, the use of acoustic and ultrasound biofeedback can significantly increase the accuracy of “r” pronunciation in children and adolescents, although few clinicians currently use the method as a means of speech sound intervention.

“Visual biofeedback enhances the sensory experience of producing a sound like ‘r,’” says McAllister Byun, a certified speech-language pathologist. “In addition to hearing the sound of speech, the child sees a visual display of her own speech and a model representing the correct pronunciation of the sound. The model creates a target. Using the visual display, the child can adjust her speech to achieve a better match with the target.”

McAllister Byun attributes the success of the treatment model to the unconventional approach it brings to the task of learning speech.

“In traditional methods, the clinician typically asks the child to imitate the “r” sound that she hears,” McAllister Byun explains. “However, many children who are unable to produce a good ‘r’ sound also have trouble hearing the difference between correct and incorrect ‘r.’ We think that biofeedback is successful because it bypasses that auditory channel. Even if the child can’t hear the difference between good and bad “r,” they can see whether they’re hitting the target on the screen.”

Even with its promising nature, very few clinicians have adopted biofeedback due to equipment costs or lack of familiarity with the method. However, recent technological advances have lowered the cost of biofeedback equipment, creating an opportunity for widespread use of these methods. McAllister Byun is currently looking to expand her research and build the case for the effectiveness of biofeedback intervention through a research grant from the National Institutes of Health. She is now seeking research participants for a new treatment study.

“We’re seeing a shift in the field of speech-language pathology toward increased incorporation of technology into treatment—whether it’s a simple iPad app or something as complex as ultrasound imaging of the contours of the tongue,” McAllister Byun explains. “My goal is to make clinicians aware of biofeedback as a tool that they can reach for when they meet these truly challenging, treatment-resistant cases.”